Provider Demographics
NPI:1295517548
Name:MAHARAJH, VANNITA (LMT, CLT, MLD-C)
Entity type:Individual
Prefix:
First Name:VANNITA
Middle Name:
Last Name:MAHARAJH
Suffix:
Gender:F
Credentials:LMT, CLT, MLD-C
Other - Prefix:
Other - First Name:VANNITA
Other - Middle Name:
Other - Last Name:NARAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT, CLT, MLD-C
Mailing Address - Street 1:8444 LEFFERTS BLVD APT 4
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3013
Mailing Address - Country:US
Mailing Address - Phone:516-500-2013
Mailing Address - Fax:
Practice Address - Street 1:8444 LEFFERTS BLVD APT 4
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3013
Practice Address - Country:US
Practice Address - Phone:516-500-2013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026709225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist